Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology

Background Catatonia, a neuropsychiatric syndrome, can be associated with inflammatory conditions of the central nervous system. Aims To explore steroid-responsive catatonia with possible autoimmune origins. Method A retrospective investigation was conducted of clinical and paraclinical featur...

Full description

Saved in:
Bibliographic Details
Main Authors: Rifat Serav Ilhan, Jonathan P. Rogers, Kazım Cihan Can, Berker Duman, Burçin Çolak, Meram Can Saka, Seyda Erdoğan, Rezzak Yilmaz, Canan Yucesan, Mine Araz, Güle Çınar, Sena Ünal, Özlem Doğan, Emine Uslu, Thomas A. Pollak
Format: Article
Language:English
Published: Cambridge University Press 2025-09-01
Series:BJPsych Open
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S2056472425108065/type/journal_article
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849238895335571456
author Rifat Serav Ilhan
Jonathan P. Rogers
Kazım Cihan Can
Berker Duman
Burçin Çolak
Meram Can Saka
Seyda Erdoğan
Rezzak Yilmaz
Canan Yucesan
Mine Araz
Güle Çınar
Sena Ünal
Özlem Doğan
Emine Uslu
Thomas A. Pollak
author_facet Rifat Serav Ilhan
Jonathan P. Rogers
Kazım Cihan Can
Berker Duman
Burçin Çolak
Meram Can Saka
Seyda Erdoğan
Rezzak Yilmaz
Canan Yucesan
Mine Araz
Güle Çınar
Sena Ünal
Özlem Doğan
Emine Uslu
Thomas A. Pollak
author_sort Rifat Serav Ilhan
collection DOAJ
description Background Catatonia, a neuropsychiatric syndrome, can be associated with inflammatory conditions of the central nervous system. Aims To explore steroid-responsive catatonia with possible autoimmune origins. Method A retrospective investigation was conducted of clinical and paraclinical features, including imagining, serum, and cerebrospinal fluid findings in ten patients presenting with subacute onset catatonia and treated with steroid pulse therapy between January 2022 and January 2024. Results A retrospective chart review identified ten patients (of a total of 56) with steroid-responsive subacute onset catatonia. Catatonia types varied. All patients were positive for delirium and psychotic symptoms. Imaging and cerebrospinal fluid results indicated non-specific signs of central nervous system inflammation. Intravenous 1 g methylprednisolone pulse therapy resulted in complete remission in all patients. Autoantibodies for limbic and paraneoplastic encephalitis were negative for all patients. None of the patients fulfilled the criteria for definite autoimmune encephalitis or autoantibody-negative probable autoimmune encephalitis. Conclusions Diagnosis of autoimmune catatonia is challenging without autoantibody markers, but steroid responsiveness, combined with clinical and paraclinical features, may suggest an autoimmune mechanism.
format Article
id doaj-art-4d00a76232fe4d85aa0f5426d00a681f
institution Kabale University
issn 2056-4724
language English
publishDate 2025-09-01
publisher Cambridge University Press
record_format Article
series BJPsych Open
spelling doaj-art-4d00a76232fe4d85aa0f5426d00a681f2025-08-20T04:01:18ZengCambridge University PressBJPsych Open2056-47242025-09-011110.1192/bjo.2025.10806Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiologyRifat Serav Ilhan0https://orcid.org/0000-0003-4609-3751Jonathan P. Rogers1https://orcid.org/0000-0002-4671-5410Kazım Cihan Can2Berker Duman3Burçin Çolak4Meram Can Saka5Seyda Erdoğan6Rezzak Yilmaz7Canan Yucesan8Mine Araz9Güle Çınar10Sena Ünal11Özlem Doğan12Emine Uslu13Thomas A. Pollak14https://orcid.org/0000-0002-6171-0810Department of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDivision of Psychiatry, University College London, London, UKDepartment of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Neurology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Neurology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Neurology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Nuclear Medicine, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Clinical Microbiology and Infectious Diseases, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Radiology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Medical Biochemistry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Rheumatology, Ankara University Faculty of Medicine, Ankara, TurkeySection of Neuropsychiatry, Department of Psychosis Studies, King’s College London, London, UK Background Catatonia, a neuropsychiatric syndrome, can be associated with inflammatory conditions of the central nervous system. Aims To explore steroid-responsive catatonia with possible autoimmune origins. Method A retrospective investigation was conducted of clinical and paraclinical features, including imagining, serum, and cerebrospinal fluid findings in ten patients presenting with subacute onset catatonia and treated with steroid pulse therapy between January 2022 and January 2024. Results A retrospective chart review identified ten patients (of a total of 56) with steroid-responsive subacute onset catatonia. Catatonia types varied. All patients were positive for delirium and psychotic symptoms. Imaging and cerebrospinal fluid results indicated non-specific signs of central nervous system inflammation. Intravenous 1 g methylprednisolone pulse therapy resulted in complete remission in all patients. Autoantibodies for limbic and paraneoplastic encephalitis were negative for all patients. None of the patients fulfilled the criteria for definite autoimmune encephalitis or autoantibody-negative probable autoimmune encephalitis. Conclusions Diagnosis of autoimmune catatonia is challenging without autoantibody markers, but steroid responsiveness, combined with clinical and paraclinical features, may suggest an autoimmune mechanism. https://www.cambridge.org/core/product/identifier/S2056472425108065/type/journal_articleCatatoniaautoimmune encephalitisautoimmune psychosis
spellingShingle Rifat Serav Ilhan
Jonathan P. Rogers
Kazım Cihan Can
Berker Duman
Burçin Çolak
Meram Can Saka
Seyda Erdoğan
Rezzak Yilmaz
Canan Yucesan
Mine Araz
Güle Çınar
Sena Ünal
Özlem Doğan
Emine Uslu
Thomas A. Pollak
Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology
BJPsych Open
Catatonia
autoimmune encephalitis
autoimmune psychosis
title Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology
title_full Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology
title_fullStr Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology
title_full_unstemmed Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology
title_short Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology
title_sort retrospective chart review of cases of steroid responsive catatonia exploring a potential autoimmune aetiology
topic Catatonia
autoimmune encephalitis
autoimmune psychosis
url https://www.cambridge.org/core/product/identifier/S2056472425108065/type/journal_article
work_keys_str_mv AT rifatseravilhan retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT jonathanprogers retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT kazımcihancan retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT berkerduman retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT burcincolak retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT meramcansaka retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT seydaerdogan retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT rezzakyilmaz retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT cananyucesan retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT minearaz retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT gulecınar retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT senaunal retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT ozlemdogan retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT emineuslu retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology
AT thomasapollak retrospectivechartreviewofcasesofsteroidresponsivecatatoniaexploringapotentialautoimmuneaetiology